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  1. Article ; Online: The impact of COVID-19 on Australian clinicians' decision making in line with the principles of Choosing Wisely.

    Giles, Megan / Terblanche, Morne / Wang, Liang / Hirani, Shashivadan P / Wu, Chiung-Jung Jo

    Nursing open

    2023  Volume 10, Issue 12, Page(s) 7788–7795

    Abstract: Aim: To explore the perspectives of clinicians' decision-making processes and considerations in line with the Choosing Wisely principles during the first wave of the COVID-19 pandemic.: Design: An exploratory qualitative approach was used.: Methods! ...

    Abstract Aim: To explore the perspectives of clinicians' decision-making processes and considerations in line with the Choosing Wisely principles during the first wave of the COVID-19 pandemic.
    Design: An exploratory qualitative approach was used.
    Methods: Data were collected via semi-structured interviews to encourage participants to discuss their own experience in making clinical decisions during the COVID-19 pandemic. A total of 12 clinicians from across disciplines were interviewed to reach data saturation. Interview data were analysed considering the Choosing Wisely principles.
    Results: Five main themes as they relate to clinician decision-making emerged and included; prioritizing care and treatment, uncertainty regarding best practice as a result of rapidly changing guidelines, organizational challenges to clinical decision-making, the use of telehealth and enabling consumer engagement with health services.
    Conclusion: Despite the disruption caused by COVID-19, clinicians were mindful of necessary care and worked to ensure that core care was not compromised during the first wave of the pandemic. The need for clinicians to protect both their own safety and that of their colleagues arose as an additional factor that influenced clinicians' decision-making process during the COVID-19 pandemic.
    MeSH term(s) Humans ; COVID-19 ; Pandemics ; Australia ; Uncertainty ; Clinical Decision-Making
    Language English
    Publishing date 2023-10-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2809556-X
    ISSN 2054-1058 ; 2054-1058
    ISSN (online) 2054-1058
    ISSN 2054-1058
    DOI 10.1002/nop2.2026
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Engaging consumers and health professionals in collaborative decision-making to optimize care.

    Wu, Chiung-Jung Jo / Giles, Megan / Terblanche, Morne / Drabble, Anne

    Nursing & health sciences

    2021  Volume 24, Issue 1, Page(s) 73–77

    Abstract: Shared communication and collaborative decision-making between consumers and health professionals is essential in optimizing the quality of consumer care. However, the consumers' ability to ask questions and seek answers, as well as health professionals' ...

    Abstract Shared communication and collaborative decision-making between consumers and health professionals is essential in optimizing the quality of consumer care. However, the consumers' ability to ask questions and seek answers, as well as health professionals' communication skills to engage with the consumer, are necessary considerations for the collaborative decision-making process. This quality improvement initiative sought to understand the context of collaborative decision making from the perspective of consumers and health professionals adapted from the international Choosing Wisely program. Findings indicated health professionals acknowledged a problem with unnecessary and overuse of tests, treatments, and procedures. Consumers suggested they were confident asking questions about their health and care. The findings of this study highlight collaborative decision-making as a worthwhile and beneficial undertaking.
    MeSH term(s) Communication ; Decision Making ; Health Personnel ; Humans
    Language English
    Publishing date 2021-11-28
    Publishing country Australia
    Document type Journal Article
    ZDB-ID 2213282-X
    ISSN 1442-2018 ; 1441-0745
    ISSN (online) 1442-2018
    ISSN 1441-0745
    DOI 10.1111/nhs.12901
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6245: Show issues Location:
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  3. Article ; Online: Doctors' and Nurses' Attitudes of Acupuncture and Acupressure use in Perioperative Care: An Australian National Survey.

    Zhang, Nancy Ming / Daly, David / Terblanche, Morne / Joshi, Sumati / Tacey, Mark / Vesty, Gillian / Zheng, Zhen

    Pain management nursing : official journal of the American Society of Pain Management Nurses

    2022  Volume 23, Issue 6, Page(s) 800–810

    Abstract: Background: Acupuncture and acupressure are not being systematically used in the management of postoperative nausea and vomiting and pain, despite being included in the guidelines.: Aim: To examine the beliefs, attitudes, and knowledge of Australian ... ...

    Abstract Background: Acupuncture and acupressure are not being systematically used in the management of postoperative nausea and vomiting and pain, despite being included in the guidelines.
    Aim: To examine the beliefs, attitudes, and knowledge of Australian nurses/midwives and doctors toward the perioperative use of AA for the management of postoperative nausea and vomiting and pain; to explore the barriers and enablers influencing acupuncture and acupressure integration into hospital setting.
    Methods: A mixed-mode approach was undertaken for data collection. An online approach was used to recruit respondents from Australian College of Perioperative Nurses. Three hospitals from three different Australian states were selected via convenience sampling.
    Results: A total of 421 usable surveys were included in data analysis. The respondents comprised 14.3% doctors and 72.9% nurses/midwives. Overall, 69.4% were female, 85% were trained in Australia with 35% and 51.4% having knowledge or personal exposure to AA in general respectively. Over 60% of the respondents agreed AA should be routinely integrated into perioperative care, and over 80% would recommend AA to their patients if it was provided at their hospital, and, 75% would be willing to receive further education. The three main reported barriers included: perceived lack of scientific evidence (80.9%), unavailability of credentialed provider (77.2%) and lack of reimbursement (60.4%).
    Conclusions: Positive attitudes are reported by Australian doctors and nurses toward AA. This is despite of low levels of knowledge or personal exposure to AA. Further studies are required to explore the implementation of barriers and address respondent calls for further education.
    Language English
    Publishing date 2022-09-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2213260-0
    ISSN 1532-8635 ; 1524-9042
    ISSN (online) 1532-8635
    ISSN 1524-9042
    DOI 10.1016/j.pmn.2022.08.008
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6269: Show issues Location:
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  4. Article ; Online: Blood management in hip fractures; are we leaving it too late? A retrospective observational study.

    Puckeridge, Gillian / Terblanche, Morne / Wallis, Marianne / Fung, Yoke Lin

    BMC geriatrics

    2019  Volume 19, Issue 1, Page(s) 79

    Abstract: Background: Anaemia in hip fracture patients has been associated with increased risk of allogenic blood transfusion (ABT), poorer functional outcomes and increased mortality. Few studies have reported the prevalence of anaemia on admission or its ... ...

    Abstract Background: Anaemia in hip fracture patients has been associated with increased risk of allogenic blood transfusion (ABT), poorer functional outcomes and increased mortality. Few studies have reported the prevalence of anaemia on admission or its progression prior to surgery in this cohort. We aimed to measure the prevalence of anaemia on admission in older persons who sustain a hip fracture, identify if anaemia develops or progresses prior to surgery, and to report associations with outcome.
    Methods: A retrospective, observational study was undertaken in a regional hospital. All patients aged 60 and over, admitted with a primary hip fracture resulting from a simple fall, in the 12 months of 2014 were included. The World Health Organization (WHO) definition of anaemia was used. Pathology databases and clinical records were reviewed to collect data. Repeated measures ANOVA's were used to quantify the progression of anaemia prior to surgery, and Chi square test were used to report associations with outcome variables.
    Results: Two hundred sixty-one patients were identified, median age was 81 years. There were twice as many females as males and just over half the sample had extracapsular fractures. Anaemia was present on admission in 45% (n = 117), highest incidence of anaemia occurred in males 52.0% (n = 39), extracapsular fractures 41.9% (n = 78) and those aged over 80 years 49.7% (n = 91). Progression of anaemia prior to surgery was significant in all groups (p < 0.05), with the greatest reduction seen in extracapsular fractures. Pre-surgery reduction in Hb was recorded in 82.3% of patients between admission and day 1, and in 71.4% between admission and day 2. There was significant association between anaemia on admission and PRBC transfusion (p < 0.05), in hospital mortality (p < 0.05) however no association with the use of antiplatelet or anticoagulant medication, nor LOS.
    Conclusions: The findings demonstrate that pre-surgical anaemia in older hip fracture patients is associated with a PRBC transfusion and increased hospital mortality. Importantly, it also identified that patients continue to bleed after admission, leading to the development of or worsening anaemia. Thus, identification anaemia in the pre-surgical period provides an opportunity for treatment to avoid transfusions and improve patient outcomes.
    MeSH term(s) Accidental Falls ; Aged ; Aged, 80 and over ; Anemia/diagnosis ; Anemia/mortality ; Anemia/therapy ; Cohort Studies ; Erythrocyte Transfusion/methods ; Erythrocyte Transfusion/mortality ; Female ; Hip Fractures/mortality ; Hip Fractures/surgery ; Hospital Mortality ; Humans ; Male ; Postoperative Care/methods ; Postoperative Care/mortality ; Prevalence ; Queensland/epidemiology ; Retrospective Studies
    Language English
    Publishing date 2019-03-12
    Publishing country England
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2059865-8
    ISSN 1471-2318 ; 1471-2318
    ISSN (online) 1471-2318
    ISSN 1471-2318
    DOI 10.1186/s12877-019-1099-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: The SCHHS hip fracture clinical network experience-Improving care and outcomes through an interprofessional approach.

    Puckeridge, Gillian / Terblanche, Morné / Massey, Debbie

    International journal of orthopaedic and trauma nursing

    2017  Volume 26, Page(s) 24–29

    Abstract: Background: Hip fractures are a major global health care issue, with the 1.26 million estimated cases in 1990 predicted to increase to 4.5 million by 2050. Varying models of care have been developed to improve outcomes following fragility hip fractures. ...

    Abstract Background: Hip fractures are a major global health care issue, with the 1.26 million estimated cases in 1990 predicted to increase to 4.5 million by 2050. Varying models of care have been developed to improve outcomes following fragility hip fractures. Most of these care models embrace an interprofessional approach to care. Specialist orthopedic nurses play an important role in the management of fragility hip fracture patients and their contribution to the interprofessional health care team is an important predictor of patient outcomes.
    Assessment of the problem: The Sunshine Coast Hospital and Health Service (SCHHS) is compromised of four hospitals in South East Queensland, Australia however only one large regional hospital provides specialist hip fracture services. Approximately, 350 older hip fracture patients present to the Sunshine Coast Hospital & Health Service (SCHHS) each year. We used Hospital Health round table (HHRT) data to identify and assess key performance care and management of hip fracture patient and outcomes at SCHHS. The HHRT is a nonprofit membership organisation of health services across Australia and New Zealand that aims to provide opportunity for Health Services to achieve best practice, collect analyse and publish information, identify ways to improve and promote collaboration and networking. Exemplars of best practice are also identified in the data so that organizations can adopt similar models of care. HHRT data identified underperformance in management of hip fracture patients in a number of quality indicators at the study site, including length of stay (LOS), time to surgery and relative stay index (RSI).
    Strategies for quality improvement: Following review of HHRT data key stakeholders undertook a quality improvement project and formed the Hip Fracture Clinical Network Group (HFCNG). This was established in 2013 with the aim of improving outcomes and achieving key performance indicators for all elderly patients who sustain a hip fracture through active collaboration and regular communication between a broad group of key clinical stakeholders.
    Results of the quality improvement project: Following the implementation of the initiative the Relative Stay Index reduced from 88% in 2012/13 to 78% in 2014/15, and the average LOS reduced from 10.4 days to 8.6 days. The percentage of patients receiving surgery within 2 days rose from 85% to 96%; demonstrating consistent outperformance of the time to surgery key performance indicator of 80%. The percentage of patients discharged to their place of usual residence increased from 45% to 54%. The rate of complications reduced slightly from 69% to 66%. Rates of hospital acquired anaemia reduced from 20.7% to 15%. Detection of delirium rose over the reporting period from 22% to 34%, enabling rapid management. We noted during this period that there was no corresponding increase in readmission rates for this group of patients. These data reflect improvement to clinical documentation and the appropriate identification of cognitive changes.
    Conclusion: In this quality improvement report, we describe how key stakeholders were engaged to improve communication and collaboration, and how the use of a national benchmarking dataset enabled health care providers to identify care gaps and inconsistencies in clinical practice. This quality improvement project markedly improved collaboration, clinical practice and patient outcomes.
    MeSH term(s) Benchmarking ; Databases, Factual ; Hip Fractures/nursing ; Hip Fractures/surgery ; Humans ; Interprofessional Relations ; Length of Stay ; Orthopedic Procedures ; Quality Improvement ; Queensland
    Language English
    Publishing date 2017-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2537649-4
    ISSN 1878-1292 ; 1878-1241
    ISSN (online) 1878-1292
    ISSN 1878-1241
    DOI 10.1016/j.ijotn.2016.12.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Remote care by telemedicine in the ICU: many models of care can be effective.

    Boots, Robert James / Singh, Sunil / Terblanche, Morne / Widdicombe, Neil / Lipman, Jeffery

    Current opinion in critical care

    2011  Volume 17, Issue 6, Page(s) 634–640

    Abstract: Purpose of review: Telemedicine, by the use of audiovisual technologies, is increasingly being used to assist in patient care by ICUs unable to be staffed by consultant intensivists. This review discusses the recent evaluation of these services and ... ...

    Abstract Purpose of review: Telemedicine, by the use of audiovisual technologies, is increasingly being used to assist in patient care by ICUs unable to be staffed by consultant intensivists. This review discusses the recent evaluation of these services and their potential role in managing intensive care patients.
    Recent findings: Models of care range from complete remote 24 h surveillance requiring direct video observation to a consultation liaison service only requiring conventional telephone links. There has been a rapid adoption of such services especially in North America where access to on-site intensive care specialists is limited for the volume of intensive care being undertaken. Early work suggests savings in terms of cost and length of stay with an improvement in compliance with care protocols. However, later work is not as supportive of such services, possibly related to differing care infrastructures and the organization of individual units. The key task is to ascertain the most appropriate service requirements that would assist in care for a given patient circumstance.
    Summary: Clear benefits of ICU-telemedicine systems remain unclear but at least the systems appear safe. Formal reviews of the impacts and contribution of ICU telemedicine to processes of care, the effects on unit staffing, hospital organization, and the healthcare region are needed. However, ICU-telemedicine is available and being embraced by some, especially to deal with the tyranny of distance.
    MeSH term(s) Critical Illness ; Health Services Needs and Demand ; Humans ; Intensive Care Units/organization & administration ; Length of Stay ; Models, Organizational ; Patient Care ; Patient Care Team ; Queensland ; Telemedicine/methods ; Telemedicine/organization & administration
    Language English
    Publishing date 2011-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0b013e32834a789a
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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